Introduction
The Actual allegations revolve around The Patent Protection and Affordable Care Act. By adding chapter 48 (Maintenance of Minimum Essential Coverage), SECTION 1501(b) amends subtitle D and thereunder, section 5000A establishes the Individual Mandate Penalty (Lawrence & Barnes, 2011, p.90). This Act requires citizens and legal residents of the US to maintain health premium coverage from an authorized private health insurance provider as from January 2014 unless otherwise exempted.
Paragraph (D) (2) of section 5000A excludes from the definition of “Applicable individual” religious objectors and members of “Health Care Ministry” (Act at 326-28). Furthermore, it excludes from the definition of “Applicable Individuals” persons who are aliens within the United States (Act at 328) (Lawrence & Barnes, 2011, p.92). Finally, paragraph (D) (4) excludes from the definition of “applicable individuals” incarcerated persons other than those awaiting disposition.
Another allegation is that no clause in the constitution grants congressional authority to enforce this Individual Mandate, which seeks to regulate the non-commercial Activity of citizens and legal residents. A review of The Budgetary Treatment of an Individual Mandate to Buy Health Insurance (1994), a proposal to enforce individual healthcare mandate, warned congress that it would be an unprecedented federal Action.
Section 5000 (b) (1) of the Act establishes a penalty. It provides that, “if an applicable individual fails to meet the requirements of subsection (a) for one or more months beginning the year after 2013, then, except as provided under section (d), there is hereby a penalty imposed concerning the individual in the amount determined under section (c) ( Act at 322). By 2016, the penalty grows to $750 per year up to a maximum of the greater of three times that amount per family or two percent of the household income (Barry et al, 2011, p.46). Thereafter, the penalty will be compared to previous months and will be growing monthly at a certain rate, based on the cost of living adjustments (Act 322-26).
Issues surrounding the case
Following a presidential assent of the Patient Protection and Healthcare Act on March 23, 2010, several issues have come up for discussion. First, the constitution does not authorize Congress to either, directly, indirectly, or under a financial threat to mandate any individual to purchase a service or good from any private organization (Kendall, 2011. p. 16). Therefore, Congress has exceeded its jurisdiction by mandating the purchase of insurance coverage from private health care insurance companies.
This, in its appearance, is an evolving scheme whereby congress forces the healthy segments of the society to purchase private health care coverage. The aim of this is to subsidize a reciprocal government mandate imposed on health insurance providers to extend, on-demand, health care coverage to previously uninsured individuals who become ill, and or are unable to pay their bills or are not eligible for Medicare (Kendall, 2011. p. 16). This mandate is not at issue in this action but it is a potential violation of the Pre-Existing Coverage Mandate.
The Act furthermore impairs the right of the young citizens and legal residents to make their own financial choices and to pursue their financial happiness in favor of the economic interests of the numerous, politically powerful, and aging generation. The constitution, whose design was to protect the rights of the minorities, does not allow congress to devise schemes to favor the interests of the numerous and politically powerful at the expense of the less numerous and political minorities.
The immediate effect of the Individual Mandate Act is to reduce the disposable income for purchases requiring long-term monthly payments. This reduction is set to grow more acute on January 1 2014 when the Act will become effective eventually reducing the purchasing power for more routine goods and services like food, education, and recreation (Kendall, 2011. p. 16). This kind of long-term reduction of purchasing power is an injury resulting directly from the Act.
Reasons for the suit
The plaintiff’s Barbara Goudy-Bachman and Gregory Bachman are residents of New York, Pennsylvania, and have a family of two children. Barbara 48, and Gregory 56 are a self-employed couple and do not qualify for Medicaid and will not qualify for Medicare until January 2014 when the individual mandate or the minimum coverage provision (constitutionality of the requirement to maintain minimum essential coverage; hereinafter referred to as “the Act”) will take effect (Lawrence & Barnes, 2011, p. 82). The plaintiffs are not members of any group that is exempt from the Act and therefore will be subject to it when it comes into effect. The plaintiffs do not have an insurance policy and will not buy one unless required to do so by law. For this reason, the plaintiffs have instituted a lawsuit to challenge the constitutionality of the Act.
The couple appreciates the fact that the healthcare crisis is nationwide in scope. In 2001, the couple had to drop all their health insurance policies because the premiums exceeded the mortgage payments. They claimed that the insurance was of no use since the insurer maintained a limit of 80% of qualified expenses and imposed a 20% deductible per occurrence (Lawrence & Barnes, 2011, p. 98). The couple has been able to meet all its medical expenses as they occur since they dropped the insurance coverage and have no outstanding medical bills.
Resulting from the Act, the plaintiffs are not able to buy a family car by or about March 2010 because they cannot afford to finance the purchase before the effective date of the Act. Secondly, they cannot finance a five-year deal because the Act will reduce and possibly eliminate their disposable income in the last fifteen months of the deal when it comes to effect (Lawrence & Barnes, 2011, p.102). The plaintiffs intend to comply with any federal law regarding Medicare, and would not voluntarily, opt to break the federal law thus subjecting themselves to the otherwise unconstitutional penalty.
Plaintiffs have, continually in the past enjoyed the satisfaction drawn from purchasing automobiles to serve their transport requirements from their approximate 450-dollar monthly disposable income. The plaintiffs, who in times past qualified, cannot continue enjoying this kind of utility because the Act will possibly eliminate their disposable income. Because of the Act, the plaintiffs have suffered concrete and recognizable injury by their inability to buy and enjoy the services of their new car by March 2010 (Lawrence & Barnes, 2011, p.102). In addition to this, the plaintiffs are unable to spend their disposable income for they have to save to pay the extraordinary minimum coverage premium when the Act comes into effect in January 2014. This owes directly to the Act.
Main points of the case
The first point challenges the decision of congress to compel private citizens, such as the plaintiffs, to buy health care insurance coverage from authorized private health insurance companies as a condition of lawful residence in the United States (Barry et al, 2011, p.48). In doing this, congress Acted outside its jurisdiction and therefore, the court should declare the Act as a violation of the commerce clause of the constitution article 1(8).
The Act has a direct proximate effect on the plaintiffs’ disposable income. As a result of the Act; the plaintiffs are not able to enjoy the services of a suitable new car of their choice on a five-year financing plan on march 27 2010 as they have to anticipate the date when the Act will take effect (Barry et al, 2011, p. 50). The plaintiffs in this sense have been denied their constitutional right of enjoying their disposable income because they have to save for the extraordinary costs of purchasing a minimum coverage from the private sector.
Ruling
In this particular case, the court ruled in favor of the plaintiffs. It was held that the Individual Mandate Act was unconstitutional (Barry et al, 2011, p.61). The rest of the act would stand only that the Minimum Coverage provision, guaranteed Issue, and Preexisting Conditions provisions were to be stricken out of the Act.
References
Barry, R. F., Thomas, L. G., Sandra, H. J., Timothy, S. J., & Robert, L. S. (2010). Health Law: Cases, Materials and Problems (American Casebook Series). US, Berkeley: West Group.42-60.
Kendall, Brent (August 13, 2011). Health Overhaul Is Dealt Setback. The Wall Street Journal, 13, 12-18.
Lawrence, A.F. & Barnes, A. (2011). Elder Law: Cases and Materials, Fifth Edition. United States, Ohio: LexisNexis. 90-105.